Patient Information
Each patient of KCHC is required to bring the following information to each appointment
Appointments
New Patient Forms
- Driver’s License or State ID
- Health Insurance Card (if you do not have insurance bring 30 days proof of total household income to apply for Sliding Fee Scale)
- List of current medication, dosage and how many times a day you take the medication
- Personal health history
- Current and past health issues and treatments
- Any recent discharge paperwork from Urgent Care or Emergency Room visits
- Immunization records
- Medical records and/or test results
- Family health history
- Any health issues that run in your family
Appointments
- Keeping your appointment with KCHC is very important. It can take a while to get in with your provider. If you are unable to keep your scheduled appointment, please contact us as soon as possible at 309-344-2225 to reschedule.
- Individuals who chronically no-show for appointments will be offered limited appointment times and/or may be dismissed from the KCHC as a patient.
New Patient Forms
- Family form
- Single